机器人结直肠手术：前50例经验

Robotic colorectal surgery: first 50 cases experience.

作者信息

Spinoglio Giuseppe, Summa Massimo, Priora Fabio, Quarati Raoul, Testa Silvio

机构信息

Department of Surgery, SS Antonio e Biagio Hospital, Alessandria, Italy.

出版信息

Dis Colon Rectum. 2008 Nov;51(11):1627-32. doi: 10.1007/s10350-008-9334-0. Epub 2008 May 17.

DOI:10.1007/s10350-008-9334-0

PMID:18484134

Abstract

PURPOSE

Laparoscopic colorectal surgery is believed to be technically and oncologically feasible. However, some limitation of traditional laparoscopic surgery may cause difficulties. Robotic-assisted surgery may overcome these pitfalls.

METHODS

From December 2005 to July 2007, 50 patients were selected for robotic-assisted colorectal resection mainly for cancer.

RESULTS

Of the 50 patients enrolled, 32 (64 percent) were men and 18 (36 percent) were women. Their mean age was 66.7 (range, 37-92) years. The American Society of Anesthesiologists' (ASA) class distribution was 13 (26 percent) ASA I, 24 (48 percent) ASA II, 12 (24 percent) ASA III, and 1 (2 percent) ASA IV. Forty-four patients suffered from cancer and six patients from benign disease. Amongst the cancer patients, 3 percent were at UICC (International Union Against Cancer) Stage 0, 36 percent at UICC Stage I, 24 percent at Stage II, 28 percent at Stage III, and 9 percent at Stage IV. The global conversion rate was 4 percent. The mean operative time was 338.8 minutes. It decreased as the experience increased (419 minutes in the first 20 cases vs. 346 minutes in the last 30 cases; P = 0.036). As a gross comparison, the results of a coeval standard laparoscopy group of patients were shown.

CONCLUSIONS

Robotic laparoscopic colon surgery is feasible and safe. A longer operating time is needed.

摘要

目的

腹腔镜结直肠手术在技术和肿瘤学方面被认为是可行的。然而，传统腹腔镜手术的一些局限性可能会带来困难。机器人辅助手术可能会克服这些缺陷。

方法

从2005年12月至2007年7月，选择50例主要因癌症接受机器人辅助结直肠切除术的患者。

结果

入选的50例患者中，男性32例（64%），女性18例（36%）。他们的平均年龄为66.7岁（范围37 - 92岁）。美国麻醉医师协会（ASA）分级分布为：ASA I级13例（26%），ASA II级24例（48%），ASA III级12例（24%），ASA IV级1例（2%）。44例患者患有癌症，6例患者患有良性疾病。在癌症患者中，3%处于国际抗癌联盟（UICC）0期，36%处于UICC I期，24%处于II期，28%处于III期，9%处于IV期。总体转换率为4%。平均手术时间为338.8分钟。随着经验的增加手术时间减少（前20例为419分钟，后30例为346分钟；P = 0.036）。作为大致比较，展示了同期标准腹腔镜手术组患者的结果。